Has anyone recovered from a schizoaffective disorder?


The term psychosis is understood to mean a whole group of diseases that very comprehensively influence and change a person's thinking and feeling, perception, drive and will as well as the experience of a person.

The disease usually runs in phases, there are acute phases and largely symptom-free times, which usually clearly predominate. Most patients experience repeated acute phases and relapses. In around 10 to 20 percent of those affected, however, there is only one acute episode. Most of those affected recover completely between the acute phases, but around 20 to 30 percent have limitations even outside of the acute phases. For example, the ability to concentrate, endurance or drive are no longer as good as they were before the illness. (...)

Early warning sign

The disease usually begins with rather unspecific changes, the so-called early warning signs. The acute phase follows when the disease progresses and countermeasures could not be taken in time. (...) The early warning signs are of particular importance. They occur before the disease becomes acute. If they are observed and countermeasures are taken immediately, an acute phase can usually be averted. In acute psychosis, those affected are often difficult to access; they live in their own world that is barely understandable for caregivers and caregivers. The patients then usually suffer a lot, but are usually not aware of their illness.

It is different with the early warning signs. These are also recognized by those affected as an indication of an impending relapse. It is quite possible to talk to those affected about the appearance of early warning signs and to consider together what needs to be done to avert an impending crisis. It is particularly helpful to have already laid down the procedure in a contingency plan. In the case of psychosis, it is important to be aware of early warning signs and to seek professional help. If they are overlooked, it becomes more and more difficult to find access to those affected in acute psychosis and to motivate them to seek treatment. (...)

There are no early warning signs that clearly and reliably indicate an impending psychosis. It is therefore extremely difficult to recognize this beforehand, especially when a psychosis breaks out for the first time. Even experts often fail to do this. Those affected or their relatives do not have to be ashamed of not having noticed what was going on when they first fell ill.


If someone has strange perceptual experiences for a short time, one will certainly not speak of a psychosis straight away. The problems must persist for a long time and have a certain extent.

Diagnoses are usually made according to criteria that have been established in diagnostic systems. (...) An example of a diagnostic system is the ICD (International Classification of Diseases), another well-known system is the DSM (Diagnostic and Statistical Manual of Mental Disorders). (...)


The following can be said about the frequency of psychoses worldwide (Bäuml 2008):

  • About 1 percent of the population will get sick in the course of their life.
  • The overall ratio of men to women is 1: 1, twice as many men as women fall ill among the under 40-year-olds, and twice as many women as men among the over 40-year-olds.
  • The age of first disease is between 18 and 23 years for men and between 23 and 28 years for women.
  • Psychoses are as common as diabetes.
  • There is no difference in frequency between different peoples and no increase in recent decades.
  • 2 percent of people with a migration background fall ill.
  • 10 percent of children get sick when one parent is affected.
  • 30 percent of children get sick when both parents are affected.
  • 2 percent of nieces and nephews get sick when an aunt or uncle is affected.
  • 50 percent of identical twin siblings fall ill when the other twin is affected. (...)


Psychosis is a complex, multi-faceted disease that, of course, has no simple cause. Today it is assumed that there is a certain willingness to become ill. Acute phases of illness arise when additional stressors (stressors) are added to the willingness to become ill. (...)

Genetic factors influence the disease, but do not fully determine it. (...) External influences on the development of the child's brain during pregnancy and during the later maturation of the brain (infections, trauma, persistent social stress, poisons) can lead to changes in the brain substance and nerve metabolism (..) .). These changes can favor the development of psychosis. (...) The early childhood environment and the family atmosphere are also important influencing factors. (...)

In interaction with acute stress (occupational overload, taking on new life tasks, anger and disappointment, losses, change of location, etc.), the increased vulnerability leads to a considerable imbalance in the nerve metabolism. The higher the vulnerability, the less noticeable the triggers have to be in order to get the disease going. (...)

Help with medication

Medicines against psychoses are called antipsychotics, also known as neuroleptics. (...) In the case of psychoses, treatment with antipsychotics is superior to all other forms of therapy (Bäuml 2008). 70 to 80 percent of patients not treated with antipsychotics will get the disease again within a year. Antipsychotics can reduce the risk of relapse to 20 percent in the first year. (...)

In addition, there are often (...) side effects, such as severe weight gain. Of course, this is very deterrent for those affected and sometimes leads to discontinuation of the medication.

Helpful handling

Luc Ciompi (1989) formulated ten basic therapeutic principles for dealing with people with schizophrenia:

  1. Systematic inclusion of the relevant social environment. (...)
  2. Standardization of the information available. (...)
  3. Awakening common, positive-realistic expectations for the future. (...)
  4. Gradual development of specific, common goals. (...)
  5. Coordination and continuity. (...)
  6. Simplification of the therapeutic field. (...)
  7. Simplicity and clarity in handling. (...)
  8. Continuous optimization of requirements. (...)
  9. Flexible combination of different therapeutic approaches. (...)
  10. Consideration of specific time factors. (...)

Accompaniment in psychosis

(...) Most of those affected try to understand the meaning of psychosis in their life. There are many indications that coping with illness is more successful when those affected can recognize such a meaning.

Professional carers should try to help those affected relate their experience of psychosis to their life experience. This only works if they dare to take a step into the other's world (Bock 2013). It is helpful for building relationships to want to understand which coping strategies the person affected has chosen, how he has integrated the illness into his self-image and not to evaluate it.

For a person affected, it can make sense subjectively to accept the role of the sick person as a new identity and to remain in it, especially if the return to reality appears less attractive than the psychosis. Also minimizing the illness or hiding phases of illness that one cannot or do not want to remember (...) are possible strategies. (...)

Helping people help themselves

To be ill with a psychosis does not mean to be permanently ill or threatened by illness. The healthy, symptom-free times predominate for most of those affected. However, you have to take active care to stay stable. Unfortunately, the risk of another psychotic crisis cannot be checked with a test stick in the urine. The most important measure to prevent relapse is therefore to pay attention to early warning signs.

In times of crisis it is often difficult to think about what you can do for yourself, so in quieter phases of life you should develop a plan and appropriate strategies for relapse prevention. The course of action in the event of an impending relapse is laid down in writing in a contingency plan. A crisis plan is a guide for those affected, relatives and professional helpers to quickly do the right thing when early warning signs appear (Bäuml 2008). A contingency plan contains four elements:

  • Individual early warning signs
  • Relief opportunities
  • Support options
  • Distributor

In addition to (...) general relief and support options, there is a great treasure trove of individually different strategies. All those affected have found that certain behaviors are helpful for them, while others are not. They discovered some things by accident.

It is not uncommon for subjective strategies to be more effective than the suggestions of professional helpers. They are always a sign of enormous ability to live in coping with illness. It is important to talk to those affected about this subjective knowledge. Experience reports on which coping strategies have proven successful in the past can also be very interesting for other people affected.


  • Download the S3 treatment guideline for schizophrenia (short version)
  • Aderhold, V .; Alanen, Y .; Hess, G .; Hohn, P. (2003): Psychotherapy of the Psychoses. Integrative treatment approaches from Scandinavia. Psychosocial Publishing House.
  • AG der Psyosesemiare (2007): It is normal to be different. Understanding and treating psychosis from the perspective of experienced and experts. Download as a PDF file.
  • Alanen, Y. O. (2001): Schizophrenia. Velcro cotta.
    [To the book review]
  • Bäuml, J. (2008): Psychoses from the schizophrenic circle of forms. A guide for patients and relatives. Springer Verlag.
  • Bock T. (2013): Dealing with psychotic patients. Psychiatrie Verlag, Basiswissen, 8th edition.
    [To the book review]
  • Bock, T. (2014): Obstinacy and Psychosis. "Noncompliance" as an opportunity. Paranus Verlag, 6th edition.
  • Bock, T .; Buck, D .; Esterer, I. (2007: Voices rich - messages about madness. BALANCE buch + medien verlag.
    [To the book review]
  • Bock, T .; Heinz, A. (2016): Psychoses - Struggle for the Self-evident. Psychiatry Publishing House.
    [To the book review]
  • Bock, T .; Klappheck, K .; Ruppelt, F. (2014): Search for meaning and recovery. Experiences and research on the subjective meaning of psychoses. Psychiatry Publishing House.
  • Buck-Zerchin, D. (2014): On the trail of the morning star. Psychosis as self-discovery. Paranus publishing house.
  • Ciompi, L. (1989): Affectlogik: about the structure of the psyche and its development. A contribution to schizophrenia research. Stuttgart.
  • Finzen, A. (2013): Schizophrenia. Understand, treat and manage the disease. Psychiatrie Verlag, 2nd edition.
    [To the book review]
  • Garlipp, P .; Halthof, H. (2015): Dealing with delusional people. Psychiatrie Verlag, basic knowledge.
    [To the book review]
  • Hansen, H. (Ed.) (2013): The meaning of my psychosis - twenty women and men report. Paranus publishing house.
    [To the book review]
  • Knuf, A .; Gartelmann, A. (Ed.) (2014): Before the voices come back. Prevention and self-help in the event of psychotic crises. BALANCE buch + medien verlag, 9th edition.
  • Schödlbauer, M. (2016): Delusional Encounters - Approaches to Paranoia. Psychiatry Publishing House.
    [To the book review]
  • Wienberg, G .; Walther, C .; Berg, M. (2013): PEGASUS - Psychoeducational group work with schizophrenic and schizoaffectively ill people. Psychiatrie Verlag, 6th edition.